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Infertility remains one of the most salient forms of reproductive trauma that individuals experience. Indeed, infertility engenders feelings of shame and social isolation. However, infertility sufferers do not experience infertility as a one-time traumatic event; rather, implications exist for family members of those who are directly experiencing infertility, especially parents of adult children. Thus, infertility affects family social support for this critical population through disenfranchised grief. Clinically, we have found that family therapy remains a powerful experience for both individuals who are experiencing infertility, as well as their family circles. Indeed, infertility engenders egregious stress on families, not just individuals and couples. To our knowledge, no family therapy interventions have addressed this area of family stress within the academic literature. We propose that Emotionally Focused Family Therapy (EFFT) is an excellent theoretical fit for treating families experiencing infertility. Within this article, we will outline a review of how infertility not only impacts individuals and couples, but also families, and how family therapy provides a salient form of healing for all involved. We will also address how specific EFFT interventions may be applied to treating families navigating infertility through our three-stage family therapy process. For families who may be reluctant to attend multiple sessions, we also propose a brief EFFT psychoeducational coaching model which still addresses concerns specifically experienced by families navigating infertility. Proposed EFFT interventions will be applied to our case example, along with clinical implications. Directions for future research are addressed. [ABSTRACT FROM AUTHOR]

Healthy family functioning is important for successful adolescent development and serves as a protective factor against adolescent behavior problems. When adolescent behavior problems exist, family therapy can help promote warmth and cohesiveness in the family, which results in healthier family functioning. Furthermore, family therapy is the gold standard for treating adolescent behavior problems. However, most of the research on family therapy for adolescents are with manualized models that have difficulty being implemented in usual care. The purpose of this study was to compare the effectiveness of family therapy in improving family functioning as compared to individually-based treatments, all of which were offered in usual care settings. Participants were 205 adolescents and their caregivers living in a large, metropolitan area. Data were collected at four time points (baseline, 3-, 6-, and 12-month follow-up) and analyzed using latent growth curve modeling. Family functioning was assessed by separate caregiver and adolescent reports of cohesion and conflict subscales on the Family Environment Scale and caregiver-reported parent-adolescent domain of the Stress Index for Parents of Adolescents. Across treatments, caregivers reported improvement in family cohesion and decreases in family conflict and parental stress. Similarly, adolescents across treatments reported a decrease in family conflict but no concomitant increase in family cohesion. Overall, there was no between-treatment differences in overall change with both conditions showing improvement in family functioning. Results indicate that both family therapy and non-family treatment in usual care for adolescent behavior problems are effective for improving family functioning, suggesting that existing treatment services are viable options for adolescent behavioral health when offered under monitored conditions. [ABSTRACT FROM AUTHOR]

Community reinforcement and family training (CRAFT) was developed to help and support concerned significant others (CSO) of people with, for example, alcohol use disorder. The aim of this study was to investigate therapists' experiences of working with CRAFT and their experiences of the CSOs receiving CRAFT. The study has a qualitative design and is based on three focus group interviews with 17 therapists. Interviews were analysed using thematic analysis. The analysis revealed six themes and four subthemes: Concerned significant others—A special group; Help prior to CRAFT—Offering information and a shoulder; CRAFT as a new and specific method (The toolbox of CRAFT, Formats for delivering CRAFT, Introducing a diary as homework and Implementing self‐help material—Alone or in combination with sessions); Moving from a lack of structure to structure; Change in CSOs from the therapists' point of view; and Change in the therapist's role (Dilemmas—Personalising the intervention). The therapists were generally satisfied with the method and found it easy to adapt to. Moreover, working using a manual was more structured than they were used to and increased feelings of working professionally with the CSOs. Specifically, most therapists found the self‐help book useful and indispensable in their work with CRAFT, but also agreed that it could not be used as a stand‐alone intervention for most CSOs. The therapists' experiences are relevant for implementation of manualised, structured approaches and group‐based interventions more broadly. [ABSTRACT FROM AUTHOR]

This paper introduces the Attachment Mapping Protocol (AMP), which is an assessment and treatment tool for use in individual psychotherapy, systemic family therapy and multifaith spiritual care, using a bio-psycho-social-spiritual model of care. Attachment theory has a long and significant history in psychology, with an evolving relationship within the above clinical domains. A central aim of this paper will be to recognize and affirm the extension of attachment theory beyond the traditional parameters of nascent parental, guardianship bonds and individual, developmental psychology, to reveal a much broader spectrum of valid attachment considerations for mental health and spiritual well-being. A case study will be applied to the interviewing instrument to demonstrate its utility for broadening assessment beyond attachment figures to include surrogate attachments of other persons, places and things. A model of spiritual discernment derived from the Spiritual Exercises of Ignatius of Loyola will undergird this larger worldview of attachment considerations. [ABSTRACT FROM AUTHOR]

The family is the primary caregiver for most patients with schizophrenia, and their roles are essential in patients' illness trajectories and outcomes. Due to this, various family interventions for schizophrenia have been developed and applied to the relatives who take care of their family members with schizophrenia. This study examined the effectiveness of existing family interventions for schizophrenia in achieving their target outcomes at both the family and patient levels by utilizing a systematic review and meta‐analysis. Combinations of terms were used to search for relevant studies from the databases. Thirty‐seven randomized controlled trials that met the inclusion criteria were included in the analysis. Based on the pooled result of the included studies, the programmes significantly improved the targeted outcomes with large effect size. The programmes' impacts on family‐related outcomes were higher than those on patients. Among the targeted outcomes, patients' treatment satisfaction and adherence and family caregivers' mental health were the most remarkable outcomes that had improved from the included programmes. Conversely, outcomes related to family relationships, caregiving experiences, perceived social support of family caregivers, and patients' medication use did not see significant improvements. The programmes delivered to individual family units and only to the family caregivers were more effective than those delivered to groups of caregivers and caregivers and patients together, respectively. Programme‐focused interventions were more effective than emotion‐focused ones. Based on these findings, an in‐home visiting nurse programme or advanced technology is suggested when applying family interventions for schizophrenia in practice. [ABSTRACT FROM AUTHOR]

The article presents an editorial focuses on the evolution and legacy of Family Process, marking the editor's farewell after 12 years of service. Topics encompass the evolution of family systems understandings, research advancements, family intervention, and the journal's unique role in promoting pluralism by accommodating diverse perspectives in family therapy and science.

The Biobehavioral Family Model (BBFM) was developed and evolved as a heuristic research model to support the investigation of pathways by which family relational function impacts individual family member wellbeing and disorder. Recently, the BBFM and its related assessment approach, the Family Relational Process Assessment Protocol (FRAP), have emerged as tools for clinical practice and training. The BBFM model will be presented, along with definitions of the dimensions constructed in the model, and research evidence in support of the model. To illustrate how the BBFM and FRAP are used in training, instructions for conducting the FRAP will be presented. Then, transcripts from two contrasting families participating in one of the interaction tasks will illustrate how, in training, the FRAP is interpreted through the BBFM lens to illuminate how these patterns of family relationship impact the identified patient. Finally, three applications of this training approach will exemplify the use of the BBFM and FRAP in the context of a Child and Adolescent Psychiatry Fellowship, a Family Medicine Fellowship, and a Family Therapy Training Program in Istanbul, Turkey. Limitations and future directions for the application of the BBFM in the exploration of multicultural aspects of family function for clinical and training purposes will be discussed. [ABSTRACT FROM AUTHOR]

Outcome research highlights the importance of the therapeutic alliance for the outcome of therapy. Meta‐analyses suggest that in family therapy, the therapeutic alliance is even more important than in individual therapy. In family therapy, however, the alliance is more complex than in individual therapy. Through empathy, authenticity and hopefulness the therapist can contribute to an effective alliance. Sometimes during the session, a therapist may experience strong emotions that are in tension with his/her therapeutic aspirations of empathetic listening, authenticity and hopefulness. A therapist might experience boredom instead of curiosity, irritation instead of acceptance, shame instead of authenticity. There is need for some kind of emotion regulation to protect the alliance. Furthermore, as some authors suggest, the therapist's emotions – even the emotions that are first glance seem harmful to the alliance – may also be useful for the therapist. Several case stories illustrate the different ways in which family therapists can deal with their emotions in the session. [ABSTRACT FROM AUTHOR]

We describe Richard Schwartz's development of the Internal Family Systems model (IFS) from his position as a Structural/Strategic family therapist. Four decades ago, Schwartz struggled to help clients who exhibited serious risk of harm to self and others. Through a process of inquiry, he began to work with the positive intentions behind his most challenging clients' harmful thoughts and behaviors. He applied foundational ideas from family systems thinking to patterns of internal experiences. As he experimented with ways of applying these ideas, he created an approach to healing. We summarize the IFS model delineating ways a range of family systems theory and practice inform its development and contribute to its best practice. Our purposes are to inform IFS practitioners who are not trained in foundational family systems models as well as to acknowledge the significant contributions family therapy theories made in the development and best practice of the IFS model. [ABSTRACT FROM AUTHOR]

In this clinical paper, the focus is on the use of questionnaires in family therapy practice. Psychotherapy research has indicated that the quality of the therapeutic relationship is the most robust predictor of therapeutic change. While the therapeutic relationship is even more important in family therapy than in individual therapy, it is also more complex. As will be illustrated in this paper, questionnaires can be useful in clinical practice to deal with the complex alliances in family therapy. In this paper, we will introduce two questionnaires: the Worries Questionnaire and the Dialogical Feedback Questionnaire. As illustrated in detailed case stories, we use these questionnaires in our practice as conversational tools rather than measuring instruments. They serve as the starting point for the therapist's reflection and for dialogues with family members. [ABSTRACT FROM AUTHOR]

This article is based on personal family therapist evolution of 30 years and how I have moved between first‐ and second‐order positions in how I work, challenge and make progress in the therapy room. With increasing confidence and experience, I have found myself in a position of "knowing" in therapy and of sharing the knowledge and beliefs I have with families, in a variety of ways. The first‐ and second‐order paradigms have many definitions (Anderson & Goolishian, Family Process, 27, 1988 and 371; Hoffman, Family System Medicine, 3, 1985 and 381) and mine concern the space between knowing and not‐knowing, between collaborative and directive therapy, and how to use these ideas in therapy. I explore aspects of this including ways of challenging, embedded questions, the move from questions to statements, and differences in responses. The essence throughout is that good therapy relies on good relationships, that skillful challenge is welcomed by families, detail is the enemy of therapeutic endeavor, and that embracing our expertise again can be a valuable asset in therapy. I contend that many experienced therapists follow similar practices but this is seldom talked about in the field. [ABSTRACT FROM AUTHOR]

Through the application of a discovery‐oriented task analysis, this research delineated specific therapist behaviors that resulted in a successful caregiver openness event in emotionally focused family therapy (EFFT). EFFT experts were recruited via email and asked to submit family therapy recordings where they believed a caregiver openness event occurred. Ten family therapy recordings were submitted by three experts. Within these recordings, 12 caregiver openness events were discovered and critically analyzed. Nine themes were identified and interventions therapists applied to accomplish these themes were delineated using the emotionally focused therapy‐coding scheme (EFT‐CS). These themes included: (1) validating and reframing the child's protected stance, (2) processing the impact of the child's unmet attachment longings, (3) validating the caregiver's blocked relational stance, (4) expanding caregiving intentions, (5) enacting the caregiver's intentions to meet the child's attachment longings, (6) processing the enactment, (7) processing and promoting caregiver accessibility to the child's response, (8) heightening the caregiver's accessible stance, and (9) enhancing shifting family dynamics. Additional findings, implications for clinical practice, training, and future research are discussed. [ABSTRACT FROM AUTHOR]

This paper describes "Turning back the clock" (TBC)—an innovative strategy addressing unacceptable or coercive youth behavior based on nonviolent principles, inspired by the nonviolent resistance movement (NVR)—also called connecting authority or caring authority (CA) approaches to guidance and supervision of parents and other adults. Variants of NVR/CA have been evaluated as effective in RCT and pre–post designs. TBC has not been evaluated regarding its effectiveness but shows promising usability in case studies. The aim of this description of the TBC strategy is to encourage development and testing of its usability on large scale to improve it and pave the way for effectiveness evaluations. The core of TBC is to create possibilities for improving behavior without delay by negotiating the social timeline narrative. This allows improvement through reenactment of events immediately after having said or done something unfortunate or unacceptable instead of waiting for the next comparable situation. Adults introduce the strategy by modeling it before youths are encouraged to improve their own misbehavior immediately without waiting for a later opportunity. Finally, adults declare that a set of unacceptable behaviors will be considered disqualifying to any request or demand, but that attempting again as if it had not happened can be a possibility: Using the TBC strategy. This declaration is intended to increase youth's interest in using TBC themselves, and with successful use reduce escalation of conflicts into coercion and threats. [ABSTRACT FROM AUTHOR]

Collaborative‐dialogic approaches to family therapy advise therapists to take a position of client‐as‐expert and promote an equality of multiple perspectives. This has led to debates about how to conceptualize power in dialogical therapies with scholars theorizing and researching power as social and negotiated through interaction. We aimed to understand power in dialogical therapy through reviewing discursive research on therapeutic conversations. We performed a systematic search of bibliographical databases PsycINFO, PubMed, and CINAHL. We reviewed the findings from 18 studies utilizing discursive analyses of collaborative‐dialogical therapy sessions and examined their findings in relation to power within interactions. We found a strong focus on the practices of the therapist rather than on those of the client. The therapist was presented as a catalyst of dialogue using minimal and active responses to promote dialogical conversations. Therapists also utilized power in response to broader institutional and social demands that may not be consistent with some interpretations of dialogical therapy. We consider practice implications where the exercise of power to direct a session facilitates dialogical interactions. [ABSTRACT FROM AUTHOR]

Existing couple therapies are generally effective for reducing romantic relationship distress and divorce, but therapy outcomes remain poor for many. Outcomes can be improved through greater understanding of session‐by‐session therapeutic processes, particularly in real‐world treatment settings. Modern couple therapy models commonly emphasize the importance of emotional experiences as key change processes, yet few empirical studies have tested the merits of this focus. The present study addresses this limitation by examining trajectories of subjective emotions and their association with change in a key relationship outcome, relationship satisfaction, among military veterans and their partners at a VA Medical Center. Partners rated their relationship satisfaction prior to couple therapy sessions and subjective emotions immediately after sessions. Consistent with hypotheses, both hard (e.g., anger) and soft (e.g., sadness) negative emotions decreased significantly over the course of therapy. Those couples with greater decreases in hard negative, but not soft negative, emotions showed significantly more improvement in relationship satisfaction. Positive emotions did not significantly change across couples in general, but those couples whose positive emotions did increase also showed more improvement in relationship satisfaction. These results suggest change in subjective emotions may be one process underlying improvement in couple therapy and lend empirical support to the emphasis on emotion‐based change processes underlying acceptance‐based and emotion‐focused couple therapies. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author explores the evolution of family therapy from the 1980s to the present day, highlighting key theoretical shifts and contributions by influential figures such as Evan Imber-Black. Topics covered include the rise of feminist perspectives, collaborative language approaches, and narrative therapy, as well as Imber-Black's significant impact on the field as a teacher, mentor, and advocate.

This article explores a case vignette of a child with complex trauma from an antiracist perspective, in the transforming spirit of family therapy as referenced in the Galveston Declaration. The case presents a boy within child-parent psychotherapy (CPP), a model that centers intergenerational attachment, trauma transmission, and play therapy. Through examination of the therapist's tolerance for integrating racism and its nuanced impact on the child's mental health presentation, we come to central assertions that improve the quality of care for all treatment relationships. We assert that families and children will receive higher quality mental health care when providers (1) acknowledge the ubiquity of racism on all people, (2) name their internalized racial reactions, (3) recognize the unique realities of racism in Black clients' lives, (4) choose to use their power in the service of the client, and (5) create trust for dialogue about the impact of racism on the client. [ABSTRACT FROM AUTHOR]

The Consolidated Framework for Implementation Research (CFIR) is a well-established framework for systematically identifying key factors influencing the implementation of programs. To enhance the classification of existing CFIR definitions, as well as its +2/-2 scoring system, this study incorporated the views of relevant experts to: i) improve how themes are scored; and ii) utilise more information regarding the frequency with which themes are identified. This structured, frequency-based approach to the CFIR's scoring process has been trialled as the CFIR-frequency (CFIR-f). Researchers thematically analysed semi-structured interview data from four groups of policy and program experts (N = 24) delivering two family-based therapies in New South Wales (NSW), Australia. Themes identified by less than 50% were excluded from further analysis. Themes identified by 50% or more of expert participants in the four groups were classified as enablers or barriers using clearly defined criteria. Each theme was allocated a score according to how many experts identified it as an enabler or barrier, and then mapped back onto the latest adaptation of the CFIR comprising 67 constructs. The CFIR-f successfully determined three enablers of, and six barriers to, implementation. Enablers included the family-based therapy programs, therapist training and participant monitoring systems. Barriers included referral, data collection and staffing difficulties, NSW adaptation issues and the suitability and safety of the programs for Aboriginal families. The same enablers and barriers were identified using both the CFIR-f and the original scoring approach, and the identified themes were successfully mapped to almost all CFIR constructs (65/67). This paper proposes a more frequency-based approach to CFIR's scoring process (the CFIR-f). By specifically utilising the frequency with which these barriers and enablers are identified, the CFIR-f engenders a list of ranked themes that service providers and policymakers can use to inform their decisions about program modification and implementation. [ABSTRACT FROM AUTHOR]

The therapeutic alliance is among the factors associated with positive results in therapy and has been extensively studied in psychotherapy. However, it has received less attention in social work and family intervention. Considering that such intervention occurs mainly within the framework of institutions and public policies, this article aims to identify the contextual factors that facilitate or hinder the therapeutic alliance between family members and social workers within the child protection system, taking the Chilean protection system as a case study. This longitudinal study followed six professional–caregiver dyads for 11 months using various qualitative techniques. The facilitating factors included the strengths approach of the child protection agency, family participation, a friendly work environment, and external supervision from a senior social worker. Among the obstacles were the high numbers of cases per professional, the undervaluing of their work, excessive workloads, stigma towards the system, and the mandatory nature of services. Facilitating factors were linked to the initiatives of the protection agency, while limitations were related to the type of welfare system. Similar obstacles and facilitators were found at the international level regardless of the kind of child protection system. The study concludes with recommendations for decision‐makers and social worker educators. [ABSTRACT FROM AUTHOR]

Objective: Multi‐family therapy (MFT‐AN) is a promising group‐based treatment for adolescent anorexia nervosa. This study aimed to explore how young people and parents perceived change to occur during MFT treatment. Methods: Young people (10–18 years) diagnosed with anorexia nervosa or atypical anorexia nervosa and their parents who completed MFT‐AN alongside family therapy for anorexia nervosa within the preceding 2 years were eligible for this study. Semi‐structured qualitative interviews were conducted. Recordings were transcribed verbatim and analysed using reflexive thematic analysis. Results: Twenty‐three participants (8 young people, 10 mothers and 5 fathers) completed interviews. Five main themes were identified; (1) Powerful connection, (2) Intensity, (3) New learning and perspective shifts, (4) Comparisons, and (5) Discharge is not recovery. There was a strong sense that being with others in a similar position in an intense environment were key factors in promoting change. Comparisons were inevitable and could promote insight and foster motivation, but could also be unhelpful at times. Participants spoke about how recovery continues beyond service use and requires ongoing attention and support. Conclusions: Through the mechanisms of connection, intensity, new learning and comparisons change is perceived to occur in MFT‐AN. Some of these are considered unique to this treatment format. Key points: Multi‐family therapy is perceived as a unique, challenging and helpful treatment for young people with anorexia nervosa.The combination of connecting with others in a similar position, the treatment intensity, new knowledge obtained in the group and the impact of comparisons between group members was described as leading to hope, increased mentalisation and change.Participants described how recovery continues beyond service use and that the end of treatment is not the same thing as recovery from anorexia nervosa. [ABSTRACT FROM AUTHOR]

The main objective of this article is to initiate a reflection on the fundamental significance, in the lives of individuals born and raised in Apulia (Italy), of returning to their homeland and roots after having relocated. Following an outline of the historical, sociological, and geographical context, the psychological analysis will focus on migration, a longstanding phenomenon in Italy, to elucidate the cultural and familial factors motivating individuals from Apulian region to depart initially and subsequently, for diverse reasons, to return. Through the depiction of a co-therapy session and the articulation of elements intrinsic to the therapists themselves, this article will shed light on the characteristics of Apulian families - culturally intertwined, matriarchal, and often possessing fluid boundaries - aiming to understand the influences that, even amidst migration, facilitate a nuanced equilibrium between attachment and separation. [ABSTRACT FROM AUTHOR]

The Turin branch of the APF, since its inception, has been characterized by and has over time consolidated an experience of integration between educational and clinical activities of those territorial services. This has manifested as a contribution to the development of clinical practices and activities of some Public Services within both the adult and developmental age areas. The presence of APF instructors, former students, and interns, in these contexts for many years, has contributed to the spread of the systemic relational model and the formation of a professional network that refers clinical cases to APF for therapeutic intervention. This article will focus on the description of "bridge" interventions between the clinical center and the Public Services, addressing the adolescent emergency that has intensified with the pandemic, exacerbating pre-existing suffering. Some of the experiences developed both within the services and in the clinical area as an attempt to respond to the profound and complex distress expressed by the young people and their families will be exemplified. [ABSTRACT FROM AUTHOR]

The article proposes a reflection on the cultural and identity factors of Calabrian territory, along the different steps of the therapeutic process. The Clinical observation at the Accademia di Psicoterapia della Famiglia in Reggio Calabria, during the first 5 years of activity, has allowed the identification of specific family configurations, characterized by dimensions such as enmeshment, secrecy and difficulty in building multiple affiliations. These seem to have a defensive function to the perceived threat before what appears different and unknown and comes from outside the family and social context. On a journey through the families (story) and territory (history) history, that combines scientific data with the narratives about the experience, the elements of clinical interest will be highlighted to reach the therapeutic alliance, to build a share code family system-therapeutic system, to propose a reflection on the protective factors for dropout reduction and co-building of a thinkable and evolutionary differentiation, which guarantees the possibility to belonging. [ABSTRACT FROM AUTHOR]

As common as the experience of outness may be in same-gender relationships, little is known about the influence of outness on same-gender romantic relationship satisfaction. Although some researchers have found increased levels of outness to positively correlate with relationship satisfaction, others have found no relationship between outness and relationship satisfaction. Through a photovoice methodology, nine participants in same-gender couples explored the impact of outness in various social arenas on relationship satisfaction. Researchers then utilized Interpretive Phenomenological Analysis (IPA) to find themes of relationship satisfaction being related to outness about the relationship and legal legitimacy through marriage. Conversely, relationship dissatisfaction was related to not displaying one's relationship across all contexts, and satisfaction was found to be impacted by partners having fear around outness, being out to support systems, and having differing levels of outness. [ABSTRACT FROM AUTHOR]

Goal: This article describes the development and implementation of a behavior intervention response team (BIRT). Pilot data indicate the successful implementation of BIRT interventions with patients and families and the positive staff response to these interventions. Methods: Patient- and family-disruptive behaviors are increasing in hospitals. Those behaviors arise from stress, financial burdens, and the mental weight of the patient's medical condition on the family. These distressed patients and their families tax an already overwhelmed staff, exacerbating the caregivers' exhaustion, depersonalization, and frustration. We recognized the need to proactively address these disruptions at our children's hospital with an interdisciplinary response. Disciplines engaged in the BIRT development included risk management, behavioral health, child life, service excellence, patient and family services, social work, and chaplaincy. Following multiple brainstorming sessions, we created a comprehensive, clear intervention strategy to engage with a disruptive patient or family. The BIRT was developed to work with both the family and their medical team to intervene at the first signs of potential disruption. Principal Findings: With the BIRT, we were able to reduce disruptive behaviors and limit the subsequent removal of problematic individuals from the facility. Of the families who worked with the BIRT, 75.8% required no postintervention follow-up. Practical Applications: The development of a BIRT can help head off disruptive behaviors and improve family-medical team relationships to support the highest quality and safest healthcare. [ABSTRACT FROM AUTHOR]

Purpose: This article reviews narrative therapy (NT) publications specific to Hong Kong over a period of 20 years. Methods: Three search strategies are adopted: using the Hong Kong Baptist University OneSearch database and Google Books index, and sending soliciting emails to local scholars and practitioners. Four research questions are asked: (a) how many related publications? (b) who are the targets? (c) who are the authors? (d) what is the type of publication ? Results: In total, there are 127 publications identified. The first NT publication is dated 1996. The most common target group is "People with Problem" (48.8%). Most authors are academics (78.7%). The publications are mostly Journal Articles (68.5%). Conclusions: Co-construction between academics and practitioners, co-researching as the landscape for co-constructing an NT community, and finally, the co-deconstruction process of local narratives are recommended as future tasks for Hong Kong related NT publications. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) have been shown to benefit from parent-implemented interventions (PIIs). This meta-analysis improved on prior reviews of PIIs by evaluating RCTs and multiple potential moderators, including indicators of research quality. Fifty-one effect sizes averaged moderately strong overall benefits of PIIs (g = 0.553), with studies having lower risk of research bias yielding lower estimates (g = 0.47). Parent and observer ratings yielded similar averaged estimates for positive behavior/social skills (g = 0.603), language/communication (g = 0.545), maladaptive behavior (g = 0.519), and to a lesser extent, adaptive behavior/life skills (g = 0.239). No other study, intervention, or participant characteristic moderated outcomes. PIIs with children with ASD tend to be effective across a variety of circumstances. [ABSTRACT FROM AUTHOR]

Background: Partners and family can play a key role in encouraging military service and ex-service personnel to seek help for their mental health. Community Reinforcement Approach and Family Training (CRAFT) was developed to equip concerned significant others (CSOs) of those experiencing substance use disorders with skills to encourage their loved one to enter treatment and improve their own well-being. It was adapted in the US for CSOs of ex-service personnel with post-traumatic stress disorder (PTSD) (VA-CRAFT). Objective: This study aimed to evaluate an adaptation of VA-CRAFT for use with CSOs of serving and ex-service personnel experiencing PTSD and Common Mental Disorders in the UK (UKV-CRAFT). Method: Acceptability of UKV-CRAFT was assessed with interviews with experts, namely key stakeholders (n = 15) working in support provision for serving and ex-service personnel. In addition, individuals who took part in a small-scale demonstrative trial of UKV-CRAFT (three CSOs and three facilitators who delivered UKV-CRAFT) provided feedback. Results: UKV-CRAFT was viewed positively, with interviewees highlighting that programmes like UKV-CRAFT filled a gap in provision for UK Armed Forces families as most services were only available to the serving or ex-service personnel. Interviewees praised how UKV-CRAFT enhanced CSO well-being and communication with their loved one. Concerns over the confidentiality of taking part in UKV-CRAFT were raised due to the perceived negative effects of highlighting a loved one's mental ill health, especially for CSOs of serving personnel. Ideas for improvement included broadening access to all CSOs regardless of whether their loved one was seeking treatment. Conclusion: Interviewees regarded UKV-CRAFT as a potentially useful intervention suggesting it could be proactively offered universally to support timely help-seeking if required. We recommend further evaluation of UKV-CRAFT on a wider scale, incorporating our recommendations, to assess its effectiveness accurately. Community Reinforcement And Family Therapy (CRAFT), a programme for the concerned significant others (CSOs) of people experiencing Substance Abuse Disorders (SUDs), was adapted for the CSOs of UK Armed Forces serving and ex-service personnel (UKV-CRAFT). UKV-CRAFT aimed to equip CSOs with the skills to encourage their Armed Forces loved ones to seek mental health treatment; it was evaluated by post-trial interviews with UKV-CRAFT facilitators, recipients, and Armed Forces stakeholders. UKV-CRAFT was found to be a useful intervention for CSOs but would benefit from further evaluation on a wider scale. Evaluation of Community Reinforcement And Family Therapy in the UK military community. [ABSTRACT FROM AUTHOR]

Background: As Posttraumatic stress disorder (PTSD) in adolescents significantly impacts their well-being, effective treatment is of great importance. Little is known, however, about the novel, multi-modal virtual reality supported, exposure-based psychotherapeutic interventions such as 3MDR in this population. Objective: To describe the 3MDR treatment of an adolescent with PTSD who did not respond to previous exposure-based PTSD interventions. Method: A 14-year-old girl diagnosed with PTSD received six sessions of 3MDR embedded in family therapy. Result: The patient tolerated the 3MDR intervention very well. Personalized music and self-selected pictures appeared to be a good fit, contributing to enhanced engagement in and adherence to the therapy. She no longer met criteria for PTSD post-intervention, and at 18 months follow-up. Conclusion: This case report suggests that 3MDR has potential as a trauma treatment for adolescents with treatment-resistant PTSD. Trauma-focused therapy for youngsters is often complicated, with a high percentage of dropouts. Elements of 3MDR such as walking, self-selected pictures, and personalized music are a good fit, contributing to enhanced engagement in and adherence to 3MDR therapy. 3MDR has potential as a trauma treatment for adolescents with treatment-resistant PTSD. [ABSTRACT FROM AUTHOR]

Although attachment seems to be 'in fashion' when it comes to discussing mental health issues, there are few evidence‐based therapy models treating attachment issues related to psychopathology. In this paper, we will briefly introduce Attachment‐Based Family Therapy (ABFT) as an evidence‐based intervention for depressed and suicidal adolescents, and its first‐time large‐scale application and implementation in a young adult inpatient care unit. We present our clinical data showing that 98% of the young adults who were proposed ABFT engage into this therapy. In our discussion we briefly describe accommodations to the young adult (YA) age and the inpatient setting and discuss hypotheses about which characteristics of young adulthood, the ABFT core interventions and the residential setting play a role in this high engagement. We discuss how adopting a shared clinical attachment‐based framework as a team might broaden the impact. [ABSTRACT FROM AUTHOR]

A systemic approach to child and adolescent psychiatry involves not only the immediate family but also the wider environment in which the subject lives. Despite growing evidence confirming the effectiveness of systemic family therapy in child and adolescent psychiatry, this approach is not well represented in inpatient services in Greece. We present systemic principles as practiced at a child and adolescent psychiatric inpatient clinic embedded in a general hospital. We consider the competencies and strengths achieved by the team within a systemic epistemology, the difficulties of functioning in a biomedical‐oriented environment, and the challenges faced during the 10‐year socioeconomic crisis and the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Children and adolescents diagnosed with an eating disorder often meet the diagnosis of another mental health disorder. In addition to eating disorders, individuals with comorbid disorders have higher suicide rates and more severe and chronic eating disorder symptoms. The present research aimed to investigate the influence of comorbid conditions on the treatment outcomes of children and adolescents that attended a public community mental health service. It was hypothesised that the patients with comorbidities would have a more extended treatment duration, slower rates of weight restoration, more hospital admissions for medical compromise, and poorer functioning than those without comorbidities. Data from 78 past patients at the Eating Disorder Program in Queensland, Australia, were analysed. Patients with comorbidities demonstrated similar recovery rates to those without comorbidities. However, those with comorbid conditions had longer episodes of treatment. The study's results support using Family Based Treatment for patients with and without comorbidities. The implications of the findings for public mental health services and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Despite strong empirical support for treatments of eating disorders, research has demonstrated a trend of clinicians deviating from protocols outlined in empirically supported manuals. The present study used a convergent mixed-methods design to understand clinicians' use of and drift from empirically supported treatments in a sample of 114 licensed clinicians in the US who had substantial experience (i.e. one-third of caseload) working with patients with eating disorders and training in cognitive-behavioral therapy (CBT), family-based therapy (FBT), and/or interpersonal therapy (IPT) for eating disorders. Results revealed that 63.7–76.3% of clinicians drift from empirically supported treatments and 71.8% were aware they deviated from empirically supported treatments. Qualitative analyses identified client differences (57.2%) to be the primary reason why clinicians drift, with less participants describing therapist factors (20.4%), treatment shortcomings (12.6%), treatment setting (11.7%), logistic constraints (4.9%) and family factors (4.9%) as reasons why they drift. These findings suggest that drift for most clinicians may be better explained under the umbrella of evidence-based practice. Clinicians also identified a number of ways in which treatment and access to treatment can be improved. This broadened understanding of the use of empirically supported treatments within evidence-based practice may serve to help bridge the gap between research and practice. [ABSTRACT FROM AUTHOR]

Pragmatic procedures for sustaining high-fidelity delivery of evidence-based interventions are needed to support implementation in usual care. This study tested an online therapist training system, featuring observational coder training and self-report fidelity feedback, to promote self-report acumen and routine use of family therapy (FT) techniques for adolescent behavior problems. Therapists (N = 84) from nine substance use and mental health treatment sites reported on 185 adolescent clients. Therapists submitted baseline data on FT technique use with clients, completed a workshop introducing the 32-week training system, and were randomly assigned by site to Core Training versus Core Training + Consultation. Core Training included a therapist coder training course (didactic instruction and mock session coding exercises in 13 FT techniques) and fidelity feedback procedures depicting therapist-report data on FT use. Consultation convened therapists and supervisors for one-hour monthly sessions with an external FT expert. During the 32 weeks of training, therapists submitted self-report data on FT use along with companion session audiotapes subsequently coded by observational raters. Therapist self-report reliability and accuracy both increased substantially during training. Observers reported no increase over time in FT use; therapists self-reported a decrease in FT use, likely an artifact of their improved self-report accuracy. Consultation did not enhance therapist self-report acumen or increase FT use. Online training methods that improve therapist-report reliability and accuracy for FT use may confer important advantages for treatment planning and fidelity monitoring. More intensive and/or different training interventions appear needed to increase routine FT delivery. [ABSTRACT FROM AUTHOR]

In this commentary paper, which draws on the authors' own past research and practice experience in the field of child sexual abuse prevention as well as a thorough knowledge of the extant literature, we argue that sibling sexual abuse challenges conventional thinking about child sexual abuse, both in terms of how the general public conceptualises child sexual abuse and in terms of our practice responses to it. Traditional service responses are often inadequate and inappropriate in situations involving sexual abuse between siblings. The question is further raised as to whether traditional service responses are appropriate for other forms of child sexual abuse. We argue that instead of siloed, individualist therapy and criminal or youth justice responses, whole-family responses are required, which draw on the principles of family therapy and restorative justice. This article challenges current practice with families affected by sibling sexual abuse, and other forms of child sexual abuse more broadly It proposes that whole-family responses that draw on the principles of family therapy should be made available to families affected by this issue alongside any individual interventions that may be required. We further recommend that consideration is given to whole-family restorative justice responses as an alternative to traditional criminal or youth justice responses, which have been found to impede family restoration and delay therapeutic support being made available to the child who has been harmed. [ABSTRACT FROM AUTHOR]

The United States has the largest incarcerated population in the world, and more than half of this population suffers from mental health disorders. A systemic review was conducted on how family therapy is discussed in the literature on incarceration using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search yield 194 articles with only 27 meeting criteria and being fully reviewed. This review magnifies the lack of family therapy inclusion in the literature concerning criminology and criminal justice. There is a lack of family therapists employed in incarcerated settings which emulates the absence of literature. The goal of this paper is to shed light on this issue and to call for more research that includes family therapy in the discussion surrounding incarceration. [ABSTRACT FROM AUTHOR]

Sickle cell disease (SCD) affects 100,000 Americans and occurs in one out of every 365 Black or African Americans births, and 1 out of every 16,300 Hispanic-Americans births. This population has been marginalized within society. Social inequalities and health care disparities are discussed in relation to the role played in receiving adequate care for SCD. Using an intergenerational perspective with the integration of a focused genogram, one can conceptualize and evaluate the intergenerational transmission of caregiving behaviors experienced with SCD. Family therapists can support and advocate for the family unit by better understanding SCD. Lastly, implications and further research are addressed. [ABSTRACT FROM AUTHOR]

SARS-CoV-2, commonly known as COVID-19, continues to have a profound affect ON adolescents and their families. Mental health professionals have seen an alarming increase in anxiety, depression, and suicidality during the COVID-19 pandemic. Adolescents face the challenge of differentiating from their families, and often place increased focus and importance on their peer group. Given the increased isolation, this paper illustrates how Satir's therapy model can be used by therapists who treat adolescents and their families related to COVID-19 specific stressors. Specifically, this paper will examine how Satir's focus on how self-worth, communication, and holistic approaches, are uniquely beneficial to treatment. [ABSTRACT FROM AUTHOR]

This systematic review work integrates the findings from studies conducted between 1991 and 2021 on the association between familial and parental factors and the impostor phenomenon, in an attempt to deepen the comprehension of the phenomenon's etiology. All four forms of familial/parental factors identified in these studies (i.e., parental rearing styles and behaviors, attachment styles, maladaptive parenting and parent-child relations, and familial achievement orientation) were generally found to be moderately correlated with the impostor phenomenon. The prominent group of studies deals with the link between parental rearing styles as an explaining variable, with 7 studies showing somewhat consistent associations between parental (low) care and over-control and an offspring's impostor feelings. However, when considered simultaneously, the parental variables are shown to be less predictive of impostor scores than some psychological variables such as self-esteem. [ABSTRACT FROM AUTHOR]

This article examines how family and couple therapists respond to uneven alliances with their clients at the micro‐level of therapeutic exchanges in the context of Interpersonal Process Recall (IPR) interviews. We operationalize uneven alliance with the interactional concept of asymmetry of affiliation. To this end, first, using conversation analysis (CA), we identify episodes of asymmetry of affiliation in the moment‐by‐moment conversation between the therapist and the client in therapy consultation. Second, applying CA to the IPR interview data, we examine how therapists orient to the episodes of the session in which the asymmetry of affiliation was identified. The findings demonstrate therapists' two key practices of orienting to the episodes of asymmetry of affiliation: (1) therapists' exclusive identification with one participant by typically invoking gender roles and (2) therapists' investigation of their agency in the emergence of asymmetry. [ABSTRACT FROM AUTHOR]

This article provides a perspective on implementing the Satir Model-Focused Couple and Family Therapy Program in Türkiye and how the first author of this article Sibel Erenel (SE), Licensed Marriage and Family Therapist, AAMFT approved supervisor, has tailored the program and the Institute. The program's main features and uniqueness are explained, as well as the program's focus on competency-based training using one major model. Furthermore, how the program aligns with international competencies is discussed. The article highlights the program's 18 years of growth in the region and the Institute's expertise, which adds credibility to the future implications and recommendations for new program developers. Overall, this article offers a comprehensive understanding of establishing Satir Human Development and Family Therapy Institute and how (SE) launched a competency-based, Satir Model-Focused Couple and Family Therapy Certificate Training Program in Türkiye, where couple and family therapy was in its infancy. Therefore, this article is a valuable resource for anyone interested in the practical application of Satir Transformational Systemic Therapy Training and CFT. [ABSTRACT FROM AUTHOR]

Medical problems can affect a person's physical health, mental health, relationships, quality of life, and the people with whom the patient is connected. Although we presume mental health professionals in Turkey work with individuals coping with health issues, there has been no prior published research. This study sought to determine how mental health professionals in Turkey approached their patients currently coping with a physical illness or disability and to what degree they collaborated with other care providers. Results revealed limited education on how to work with patients and their families currently coping with illness or disability, low interdisciplinary collaboration, and low family involvement in mental healthcare related to medical issues. The authors discuss how mental healthcare providers can use the findings of this study to advance systemic training and improve the use of systemic approaches for patients and their families coping with illness and disability in Turkey. [ABSTRACT FROM AUTHOR]

Couples therapy is an effective intervention for relationship problems. Despite the growing need and interest in online couples therapy during the pandemic, there is a dearth of outcome and/or process research. The current study applies the Hermeneutic Single Case Efficacy Design (HSCED) to examine the effectiveness of couples therapy across 24 weeks of treatment with a young couple who had to stay apart during the pandemic. A rich case record consisting of quantitative measures, change interviews and a case file was gathered. Based on the information, the authors developed opposing (affirmative and skeptic) arguments regarding whether the client changed over therapy and whether therapy was responsible for these changes. The results showed some improvement in the couple's relationship attributes, attachment behaviors as well as presenting problems. The couple attributed most change to the therapy process and the relationship that they have with their therapist. It appeared that the change took place over the first 16 sessions, and together with extra-therapeutic factors, online couples therapy appeared to contribute to this change. The complex, nonlinear, and multi-layered nature of change in couples therapy was discussed in terms of clinical implications. [ABSTRACT FROM AUTHOR]

Alcohol use disorder is a chronic, relapsing and remitting illness with limited efficacy of pharmacotherapy in preventing relapse. Several non-pharmacological treatment options are usually used to improve treatment outcomes. In this case report, the patient with alcohol use disorder (as per Diagnostic and Statistical Manual 5th edition criteria) had memory impairments, which was seen to limit the effectiveness of cognitive approaches such as motivational enhancement therapy. Covert sensitization, a behavioral technique based on operant conditioning, was considered an alternative option along with pharmacotherapy to enhance abstinence and was seen to be effective in creating an association between alcohol use and unpleasant consequences in the patient. We observed an improvement in subjective craving and motivation to abstain following the therapy sessions. This highlights the use of covert sensitization as an alternative non-pharmacological intervention for patients with alcohol use disorder with cognitive impairments. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to assess families' resource use and to explore parents' experiences of the Sofia model, a family-based intervention for parents with substance use disorder (SUD). Methods: Interviews were conducted with 14 parents. Data were analyzed with qualitative content analysis. The resource use assessment was estimated based on data for 40 families referred to the Sofia model and 30 reference families. Results: Parents described difficulties accessing family support and differences in received services in the Sofia model. The intervention lacked focus on the children. Families' communication regarding substance use did not increase. Resource use estimations indicated larger use of services by families in the Sofie model, but little co-parent and child-specific support. Conclusions: The intervention failed its aim to focus on the children, and enhance communication about SUD. Parents voiced a need for more long-term comprehensive support for their children and themselves. [ABSTRACT FROM AUTHOR]

Given the importance of parent involvement and parent-implemented interventions in achieving maximum child outcomes, practitioners need valid measures to assess and monitor family outcomes in developing and delivering effective and sustainable interventions. This study examined the structure of the Family Outcomes Survey, Form A, using a sample of 467 caregivers of young children diagnosed with or at increased likelihood of autism in China and identified significant predictors of the five family outcomes. Findings supported a five-factor model but a poorer fit was reported when the overall family outcome factor was added to the model. Modeling shared variance between some items under Outcome 4, "having support systems," and Outcome 5, "accessing the community" was found to significantly improve the model fit. Among the analyzed child and family characteristics, the number of hours that the caregiver spent with the autistic child, caregivers' employment status, family income, and caregivers' educational attainment were found to be significantly associated with Family Outcomes Survey, Form A scores. Implications of the findings are discussed. Efforts to measure, document, and monitor family outcomes can be helpful to practitioners in developing and delivering effective and sustainable interventions. Researchers have developed the Family Outcomes Survey, Form A, for measuring the outcomes experienced by families of children in the early intervention/early childhood special education system. Little has been reported on how well the five outcomes on the Family Outcomes Survey, Form A describe the experiences and expectations of families of autistic children in China. We conducted a survey using the Family Outcomes Survey, Form A, Chinese version with 467 caregivers of young autistic children in China. First, the five-outcome structure of the Family Outcomes Survey, Form A seemed to be appropriate for measuring family outcomes of autistic children in China. We also found that the Chinese caregivers of autistic children seemed to give general lower ratings on all five outcomes on the Family Outcomes Survey, Form A as compared to caregivers of children in early intervention/early childhood special education in Western countries like the United States and Australia. Furthermore, caregivers' ratings on the five Family Outcomes Survey, Form A outcomes seemed to be related to their educational attainment, employment status, family income level, and how much time caregivers spent with their autistic child. This study supported the use of the Family Outcomes Survey, Form A, Chinese version with families of autistic children in China. We also discussed how the coronavirus disease 2019 pandemic could have impacted the family outcomes as reported by the Chinese caregivers. [ABSTRACT FROM AUTHOR]

Family Check‐up (FCU) was introduced in Sweden more than a decade ago. Little is known about what parents experience as FCU's key mechanisms leading to changes in parenting. The aim of this study was to investigate Swedish parents' satisfaction with FCU, and their experiences of facilitators and barriers for making changes in their parenting. A mixed methods approach was employed using a parent satisfaction questionnaire (n = 77) and focus groups (n = 15). General satisfaction with FCU was adequate, with an average rating of 4 on a five‐point scale (range 3.1–4.6). The analysis of quantitative and qualitative data resulted in eight themes representing facilitators and four themes representing barriers, organized into three categories: (1) access and engagement; (2) therapeutic process; and (3) program components. Ease of access to FCU facilitated initial engagement. Individual tailoring and access to FCU during different phases of change facilitated sustained engagement and change. Therapeutic process facilitators were a meaningful, supportive relationship with the provider, psychological benefits for parents and benefits for the whole family. Program components that facilitated change in parenting were new learning of parenting strategies and use of helpful techniques such as videotaping and home practice. Negative experiences with service systems prior to starting FCU, parent psychological barriers, and parent‐provider mismatch were described as potential barriers. Some parents desired other program formats that were not offered, and some felt that new learning was insufficient to improve child behavior. Understanding the parent perspective can contribute to successful future work with implementing FCU. [ABSTRACT FROM AUTHOR]

Background: There is a global need for interventions that support the wellbeing of people living with dementia and their family care partners. Studies show that shared musical activities may achieve this. Our systematic review aimed to synthesise existing research exploring dyads' experiences of shared musical activities across a range of contexts. Method: From 31 October 2020 we searched PubMed, PsycInfo, CINAHL Complete, EMBASE, RILM, Web of Science Core Collection, Google Scholar and ProQuest Dissertations & Theses for studies published up to 14 April 2021, and hand searched five music therapy journals plus citation lists. Thirteen qualitative studies reporting on dyads' experiences and perspectives of shared musical activities across a range of settings were included. Studies with mixed populations or mixed modality interventions were excluded. We analysed the final studies using thematic synthesis, engaging in reflective discussions and reflexivity throughout. The quality of included studies was assessed using the CASP qualitative checklist. This study is registered on PROSPERO: CRD42020169360. Results: Six themes were identified from 13 studies: 1) shared musical activities support wellbeing for people living with dementia, 2) music groups become ecological systems, 3) shared musical activities are experienced differently over time, 4) shared musical activities are experienced by me and as we, 5) music is a supportive structure, and 6) the thread of connection (an overarching theme). A GRADE-CERQual assessment found moderate to high confidence in these findings. Findings informed the development of the Contextual Connection Model of Health Musicking. Conclusion: Shared musical activities foster experiences of connection for people living with dementia and their family care partners. Experiences of connection are supported through professional facilitation and the structural aspects of music, and are influenced by the setting and changes over time. These experiences of connection play a central role in supporting dyadic and individual wellbeing. These findings are largely relevant to a western cultural context; future research should seek to include more diverse cultural experiences. [ABSTRACT FROM AUTHOR]

Background: Family‐systems interventions have been proposed as one way of supporting families of people with an intellectual disability (ID) or who are autistic. This systematic review aimed to summarise what family‐systems interventions have been studied with this population, what evidence there is for their effectiveness and families' experiences of the interventions. Methods: The review was preregistered on PROSPERO (CRD42022297516). We searched five electronic databases, identified 6908 records and screened 72 full texts. Study quality was evaluated using the Mixed Methods Appraisal Tool, and a narrative synthesis was used. Results: We identified 13 eligible articles with 292 participating families. Most studies reported positive effects of the interventions on wellbeing and family relationships, and families reported positive experiences. However, research quality was poor and there are no any sufficiently powered randomised controlled trials demonstrating family‐systems interventions' effectiveness for this population. Conclusions: There is a need for higher‐quality research to establish whether family‐systems interventions are beneficial for families of people who have an ID or who are autistic. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a common mood disorder. It has been shown that adolescents are more likely to experience depression during this term, with high recurrence rates and poor functional outcomes. The central purpose of this study was to investigate the effectiveness of family therapy on the psychological capital dimensions of adolescents with MDD. Methods: The study was quasi-experimental, with a pre-test, post-test, and control group. The statistical population of this study was all adolescents with MDD who were referred to psychological clinics in Tehran, Iran, from October to December 2022. In this study, 30 eligible patients were selected and invited to take part purposefully. Researchers randomly divided the participants into two groups: a family therapy counseling group (n = 15) and a control group (n = 15). The interventions were held in eight 90-minute sessions, one session per week, and were designed and implemented to enable adolescents with MDD to promote their psychological capital dimensions based on the family therapy protocol. Beck Depression Inventory-ll (BDI-II) and Psychological Capital Questionnaire (PCQ) were administered. Data were analyzed with SPSS software using multivariate analysis of covariance (MANCOVA). Results: Family therapy intervention had a positive and significant effect on resilience (P < 0.001, F = 22.08), self-efficacy (P < 0.001, F = 18.54), hope (P < 0.001, F = 29.37), and optimism (P< 0.001, F = 21.50) in adolescents with major depression. Conclusion: Family therapy increased resilience, self-efficacy, hope, and optimism in patients with MDD. Therefore, family therapy for adolescents with MDD is recommended to increase the psychological capital dimensions and improve their quality of life (QOL). [ABSTRACT FROM AUTHOR]